Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 01067207A | IN |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 01067207A | IN |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | ME139839 | FL |
NPI | 1285857516 |
---|---|
Provider Name | Dr. Samantha Michelle Sublette |
First Address | Naples, FL 34102-5820 |
Second Address | Naples, FL 34102-5820 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 07/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000990787 | ANTHEM PIN (01) | IN |
201029980 | (05) | IN |